Cannabis use in children

Marijuana, cannabis, THC, and CBD are among the many common words and forms of cannabis that pediatric patients are being exposed to in our current day and age. Keep up to date about the official AAP policy and recommendations with today's episode. 

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This episode was written by pediatricians Tammy Yau and Lidia Park. Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.  

Key Points: 

• At the time of this episode release, marijuana is considered a schedule I drug at the federal level meaning here is high potential for abuse, no medical use, and/or lack of safety with using this drug. The official AAP stance is to avoid cannabinoid use in most children. More studies need to be done to determine the long term effects. 
• Cannabis plants generally have both THC and CBD which are types of cannabinoids. THC can cause intoxication, analgesia, and antiemesis. CBD is less intoxicating and anxiolytic.  
• Cannabis intoxication can cause tachycardia, hypertension, red eyes, dry mouth, orthostatic hypotension, increased appetite and thirst, drowsiness, insomnia, anxiety, short term memory loss, ataxia, stroke, nystagmus, hypothermia, hypotonia, and rarely respiratory depression. Treatment is supportive. 
• THC can be detected in breastmilk. There is not enough information about long term safety and implications of THC exposure in utero or while breastfeeding.  
• In children, epidiolex is the only plant derived cannabinoid FDA approved for use of severe seizures in children. 

Sources: 

• Ammerman S, et al. The impact of marijuana policies on youth: clinical, research, and legal update. Pediatrics. 2015 Mar 1;135(3):e769-85. doi: 10.1542/peds.2014-4146 
• Hale’s Medications & Mothers’ Milk 2023: A Manual of Lactational Pharmacology 
• Fischedick J, Van Der Kooy F, Verpoorte R. Cannabinoid receptor 1 binding activity and quantitative analysis of Cannabis sativa L. smoke and vapor. Chem Pharm Bull (Tokyo). 2010;58(2):201-207. doi:10.1248/cpb.58.201